| NPI | 1720712433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS T-5281) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA LT000913) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 33229) | |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2024-07-18 |